SUMMARY: Responsible for assignment of accurate
Evaluation and Management (E&M) codes, ICD diagnoses, current procedural
terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS),
modifiers and quantities derived from medical record documentation (paper or
electronic) for outpatient encounters.
Trains and educates MTF staff on coding issues and plays a significant
role in coding compliance activities.
Mandatory knowledge and skills:
Position requires excellent
computer/communication skills for provider and staff interactions.
Knowledge of anatomy/physiology and
disease process, medical terminology, coding guidelines (outpatient),
documentation requirements, familiarity with medications and reimbursement
guidelines; and encoder experience.
Candidate must have ability to
handle multiple projects and appropriately prioritize tasks to meet deadlines.
Education/Certification. The following are
Registered Health Information
Technologist (RHIT), Registered Health Information Administrator (RHIA),
Certified Professional Coder (CPC) CCS-P (Certified Coder Specialist –
Physician (CCS-P) with the appropriate level of experience.
An accrediting institution
recognized by the American Health Information Management Association (AHIMA)
and/or American Academy of Professional Coders (AAPC) must accredit
Continued Education Requirements: Contract medical
coders will obtain the required continued education hours at no expense to the
government in order to maintain current and proper national certification(s)
required for the position.
Experience. A minimum of three year experience in
the outpatient setting (physician’s office or ambulatory surgery centers)
within the last five years, including assignment of E&M, CPT, and HCPCS
specialties encompass different medical specialties (i.e. Family Practice,
Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and
HCPCS codes. Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.)
that usually do NOT use E&M codes do not count as qualifying experience.
Additionally, coding, auditing and training exclusively for specialties such as
home health, skilled nursing facilities, and rehabilitation care will not be
considered as qualifying experience. Coding
experience limited to making codes conform to specific payer requirements for the business office (insurance
billing, accounts receivable) is not
a qualifying factor. Two years of
outpatient/ambulatory surgery experience may be qualifying if received in a
military medical facility.
The work is primarily sedentary.
Requirements may include prolonged walking, standing, sitting or
bending. Carrying or lifting of medical
records may be required daily. Use of
one or more computer programs and monitors may be required daily.
Responsible for assignment of accurate
E&M, ICD, CPT and HCPCS codes and modifiers from medical record
Identifies and abstracts information
from medical records (paper or electronic) for special studies and audits,
internal and external.
Interacts with MTF staff to ensure
documentation is clear and supports coding assignments. Educates MTF staff through individual or
group in-services and training sessions.
Maintains a delinquency report of
missing records in order to facilitate completion of work within the required Air